‘People are frightened’: Across rural Illinois, economic frustrations mix with anxiety over COVID-19

Cindy Backstein worries about her 88-year-old mother, who lives in a locked-down Jasper County nursing home where dozens of people have been infected with COVID-19.

At the same time, she is anxious about the business she and her husband run 110 miles away on the outskirts of Springfield. This would normally be the busiest season of the year for Central Illinois Inflatables, which rents bouncy houses and waterslides to parties and festivals, she said. Instead, all the inflatables remain folded up in her garage, and revenue is at zero.

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Backstein’s predicaments reflect a mixture of fear and frustration that is taking hold across the wide-open expanses of rural Illinois. Social distancing comes with the territory in a region sometimes called the Corn Belt, and the spread of the virus has come slower than in the densely populated Chicago area. But in some pockets of the state, such as Jasper County, the impact has been serious.

With just 9,600 residents, Jasper County has an infection rate second only to Cook County in Illinois. Nearly all of the cases are related to the Newton Care Center, where Backstein’s mother lives, but barely more than 200 tests have been conducted in the county, according to the local health department.

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Cindy Backstein and her son, Brandon, spend time in an equipment warehouse at their home, April 29, 2020, in Springfield. Her mother lives in a nursing home in Jasper County with dozens infected by COVID-19. She and her husband, George Backstein, own and operate Central Illinois Inflatables, which rents out inflatables, games, waterslides, concessions and laser tag in the Springfield area. Because of the coronavirus, pandemic and Gov. J.B. Pritzker's statewide restrictions on group gatherings, the business is currently inoperable. (John J. Kim / Chicago Tribune)

The outbreak there started with an infected EMT delivering a patient by ambulance to the Newton Care Center from a hospital in another county, local officials said. In Randolph County, 60 miles south of St. Louis, one person infected five more at a gathering on the last day before restaurants and bars were closed in mid-March. In Sangamon County, there are 169 cases spread across nearly 200,000 residents, but one nursing home outside of Springfield accounts for about half of them, including five deaths.

But even as the number of confirmed cases rises daily downstate, so does the rhetoric from local Republican officials pushing back against Gov. J.B. Pritzker’s extended stay-at-home order. Since state Rep. Darren Bailey, R-Xenia, filed a lawsuit and received an injunction against the governor’s order on Monday, numerous officials — from county board members in southern Illinois to the state’s attorney in Woodford County across the Illinois River from Peoria — have made a range of comments seeking to undermine the order.

Backstein said she fully supports Bailey’s effort to thwart Pritzker’s order. But her family also has felt the pain and anxiety associated with the risk of exposure to the virus. Her father also lived at the Newton Care Center and died at age 90 on Easter Sunday, though not from COVID-19, she said.

“He did not die of the virus, but he was a victim of the virus because his family could not be with him,” said Backstein, who grew up in Newton before heading off to nursing school in Springfield in 1976. The funeral was family only, and her mother could not attend because of the risk. Backstein and her siblings worry constantly about their mother, who has tested negative three times for the coronavirus.

Political signs on a storefront next to the office of State Rep. Darren Bailey, R-Xenia, April 29, 2020, in Louisville, Illinois. (John J. Kim / Chicago Tribune)

Her support for Bailey is driven by her economic anxiety and her dissatisfaction with Pritzker, whom she believes is focusing all of his attention on the Chicago area while discounting the circumstances in the rest of the state.

“I think things need to open back up for those who can social distance, and you have to wear a mask,” Backstein said. Bailey “is so right: that people may save their lives but lose their livelihoods.”

After being turned down in the first wave of federal relief from the Paycheck Protection Program, Backstein and her husband received an email from their bank late Thursday saying they had been approved in the second round. That money will help, she said. The couple are also trying to apply for state unemployment payments for self-employed business owners.

Jasper, Randolph, Monroe, Jefferson and Warren counties are among several rural communities that have seen troubling outbreaks that rival the infection rates seen in the Chicago area. Chicago and the five collar counties adjacent to Cook County accounted for about 90% of the state’s 52,918 confirmed cases as of Friday. However, county health directors and doctors at regional hospitals are still wary, knowing that a relatively small group of very ill people could quickly overwhelm their more limited supplies of intensive care beds and respirators.

The population in rural areas also skews older than in cities and suburbs, and a significant proportion of jobs are in health care, raising the risks.

Jasper County coroner and funeral director Jason Meyer at his desk at Meyer Funeral Home, April 29, 2020, in Newton. The county has reported at least 44 cases of COVID-19, and at least five deaths. (John J. Kim / Chicago Tribune)

“For the most part, yes, we understand we’ve got to be safe,” said Jason Meyer, who is both Jasper County’s elected coroner and the funeral director in Newton.

But it has not been easy.

“The hardest thing has been we can’t go to church,” said Meyer, who has handled funeral arrangements for all five COVID-19 victims in Newton. “That is one of the greatest social gatherings we have.”

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Angela Oathout, the public health director in Randolph County, which had 156 cases as of Friday, said it took residents a while to grasp the gravity of the situation.

“Trying to get people to change their lifestyle — that’s been causing some of our problems," she said. “We want to socialize. Trying to eliminate what is a natural reaction … you want to go talk to somebody — it has been difficult for our residents to adjust to that.”

Randolph County traced its first infection to a social gathering during the March 15-16 weekend when Pritzker announced that bars and restaurants were being closed on the 17th.

“The gathering was the day before the governor closed the bars and restaurants,” Oathout said. “If you’re open, they’re going to socialize. You can’t get mad at people.”

Over the following weeks, she said, she pressed the seriousness of the issue with the county’s 32,000 residents in a public information campaign through local newspapers and radio, as well as her department’s Facebook page. So far, there has been only one recorded COVID-19 death in her county, according to state figures. However, in adjacent Monroe County, which also has a population of 32,000, there have been 10 deaths among just 69 recorded cases of infection, according to the Illinois Department of Public Health.

Fewer hospital beds, older populations and limited testing capacity present rural areas with serious risks even if they don’t have the giant numbers of cases facing big cities, said Michelle Patch, an expert in emergency response to medical crises who teaches at Johns Hopkins University’s School of Nursing in Baltimore.

“It is starting to get into the rural areas,” she said. “People are frightened. They are worried about their economic situation and just want to get past this and get back to normal. But there are a lot of individuals who recognize that this isn’t under control. Regardless of their political affiliation, they’re taking this seriously.”

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Johns Hopkins has been tracking COVID-19 data during the pandemic, and Jasper County burns deep red on the website’s heat map, standing out against a sea of pale pink surrounding counties.

Although county officials said no one was currently hospitalized with COVID-19, the outbreak is afflicting the most vulnerable — nursing home residents. Of the 44 people who had tested positive by Friday, 12 were in their 80s and 13 were in their 90s, according to the Jasper County Health Department.

A message of encouragement on a lawn sign is posted at Newton Care Center nursing home on April 29, 2020. (John J. Kim / Chicago Tribune)

Nearly all of the cases have been affiliated with the Newton Care Center.

“They’re either residents there, or they are workers there,” Meyer said. Local residents have donated personal protective equipment to the nursing home to make sure staff have what they need, he said.

“Our community has really pulled together to assist in any way we can,” he said.

A relatively small number of tests completed makes it difficult to know how widely the virus may have spread in the community. As of Friday, 203 of the county’s roughly 10,000 residents had been tested, according to the Jasper County Health Department.

The lack of testing is as much of an issue downstate as it is in the city, said Dr. Michael Cruz, COO of Peoria-based OSF HealthCare. The Peoria area — a mix of urban, suburban and rural communities across three counties — has seen a relatively small number of cases for its size. But doctors know they may not be seeing the whole picture.

“The problem is the testing,” Cruz said. “We actually don’t know the prevalence. But it’s here. … We’re going to get into this peak.”

Medical services in rural places can be modest. There are no hospitals in Jasper County, although four regional hospitals all maintain small clinics in Newton. One medical clinic is conducting testing at the Newton Care Center, but there is no testing facility for the general public in Newton.

Twenty-five miles away in Effingham, doctors at HSHS St. Anthony Memorial Hospital are keeping tabs on the Jasper County situation, said Dr. Ryan Jennings, chief medical officer of the 133-bed hospital.

The HSHS network, which operates several facilities in central and southern Illinois, has designated two of their hospitals — St. John’s in Springfield and St. Elizabeth’s in O’Fallon — as COVID-19 care sites, Jennings said. “We have established a seamless process for transferring patients that ensures high-quality care and appropriate isolation practices,” he said.

Though Jasper County provides a cautionary note about the need to take the spread of the pandemic seriously outside of densely populated urban centers, resentment of Pritzker’s ongoing stay-at-home order becomes more vocal by the day.

Leading the efforts to thwart the restrictions is Bailey, whose House district includes Jasper County. On Monday, a judge in neighboring Clay County granted a temporary injunction allowing Bailey — and only Bailey — to ignore the governor’s order. On Wednesday, a second Republican state representative, John Cabello of Machesney Park, filed a companion lawsuit in Winnebago County.

Some law enforcement leaders downstate have said they won’t enforce Pritzker’s order. Woodford County State’s Attorney Gregory Minger told the Peoria Journal-Star he would not prosecute any business or person who violated it.

Bailey has argued that the mounting job losses from shuttered stores and factories — there are multiple auto part makers in or near his district — are too much to bear.

Nonetheless, when asked about spreading the coronavirus through social contact, he acknowledged the seriousness of the threat.

“People are smart. People are taking this seriously,” he said, adding that COVID-19 won’t be the last challenge of its kind. “The fact is, at any point in the years to come, we can, and probably will, face these things again. We’ve got to adapt and move on rapidly. It cannot shut us down.”

The state filed an appeal on Wednesday over the ruling, which Pritzker called “absurd,” saying it set a “dangerous precedent.”

Amid the political debate, doctors and scientists are trying to stay focused on the virus.

In Peoria, doctors at one of downstate’s biggest medical centers are studying data on the crisis from big cities and other countries, trying to get ready for a surge in cases that is likely several weeks behind Chicago’s.

But there is only so much that data can predict about human behavior.

“The models are all over the place. We’ll remain ready indefinitely, and pray that it’s not going to be as big” as feared, said Stephen Hippler, chief clinical officer of OSF HealthCare, which runs OSF St. Francis Medical Center in Peoria and 13 other hospitals.

In addition to hospitals in downstate cities, such as Bloomington, Urbana, Danville and Rockford, OSF also operates Little Company of Mary Medical Center in south suburban Evergreen Park, which has been treating large numbers of COVID-19 patients from the South Side of Chicago. Medical teams in Peoria have been closely studying the stress put on that hospital.

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OSF’s Cruz said administrators have learned a lot about the burn rate for PPE and paralytic drugs used to intubate patients needing ventilators, as well as the strain that long hours and risk of infection places on staff.